Ethics and Values in Pharmacy Part-1

Contact InformationInstructor: Amal M. Badawoud, PharmD, PhD, FHEAOffice Hours: Sunday & Monday: 1:00 pm – 2:50 pm (by email)Office Location: College of Pharmacy, Third floor, Office # 3.322Email: AMBadawoud@pnu.edu.sa

Course OverviewTitle: Ethics and Values in PharmacyInstructor: Amal M. Badawoud, PharmD, PhD, FHEACourse Code: CPP 302Reference: Veatch RM, Haddad AM. Case Studies in Pharmacy Ethics, 3rd edition. Oxford University Press, 2017.

Learning Outcomes

  • Identify the four fundamental questions of ethics.

  • Apply problem-solving models to ethical issues in clinical cases.

  • Analyze necessary clinical and situational information for ethical analysis.

  • Identify and define relevant ethical principles in clinical contexts.

  • Evaluate options to determine morally justifiable choices.

  • Distinguish evaluative judgments in clinical practice.

  • Differentiate between ethical judgments and other evaluative judgments.

The Four Questions of Ethics

  1. What makes a judgment an ethical one?

    • Understand the criteria for making ethical judgments; these include the impact on well-being, rights, and justice involved in actions.

    • Implement steps to clarify ethical problems, such as differentiating between evaluative statements (opinions) and factual ones (objective truths).

  2. Who should make decisions?

    • Engage stakeholders, including patients, healthcare providers, and ethical committees to explore who should be involved in decision-making processes regarding patient care.

Determining Right Actions

  • Explore normative ethics and general principles related to what makes acts right or wrong through two primary theories:

    • Consequentialism: Right actions are defined by their outcomes; the greatest good for the greatest number of people is the guiding principle.

    • Deontological Ethics (Duty-Based): Actions are right if they follow established duties or rules, regardless of the consequences. For example, telling the truth is regarded as a moral duty even if it leads to negative consequences.

Applying Rules to Situations

  • Recognize that general ethical principles must be adapted to unique cases. Understand the functions of rules:

    • Summarize experiences from prior situations to inform current decisions.

    • Specify mandatory behaviors to guide protective actions that respect both patient and healthcare provider rights, like in cases of abortion or assisted suicide.

What Should Be Done in Specific Cases?

  • Analyzing specific situations often requires integrating prior ethical reasoning to arrive at a comprehensive analysis.

    • Explore complex ethical conflicts, such as balancing abortion rights against healthcare provider rights and how individual beliefs may influence these conflicts.

    • Decision-making processes must consider elements of patient autonomy, healthcare obligations, and the ethical guidelines governing practice.

Levels of Ethical Analysis

  • Metaethics: Investigate the source and justification of ethical claims. Assess whether ethical principles originate from societal consensus, legal frameworks, or philosophical doctrines.

  • Normative Ethics: Focus on identifying principles and values that govern ethical behavior.

  • Rules and Rights: Structure discussions around ethical frameworks that apply to various contexts.

  • Specific Cases: Conduct contextual analysis to determine the applicability of ethical principles in real-world scenarios.

Five-Step Model for Ethical Decision-Making

  1. Recognize a moral issue.

  2. Gather necessary information and assess the situation thoroughly to get a clear understanding.

  3. Identify the ethical problem; pinpoint any conflicting ethical principles at play.

  4. Seek potential resolutions that respect all parties involved.

  5. Collaborate with others in choosing a best course of action; consult with colleagues, ethical guidelines, or case studies.

Application of the Five-Step Model (Case Study)

  • Case: Reporting a Possibly Lethal Error

    • Context: Two patients are in critical condition, and there is an ethical dilemma regarding a medication dispensing error.

    • Steps Overview:

      • Gather clinical and situational information to assess the implications of the error.

      • Address moral accountability and remain sensitive to the emotional nature of the situation for patients and families.

      • Examine ethical principles, particularly beneficence (acting in the best interest of patients) and nonmaleficence (an obligation to not inflict harm).

Ethical Principles in Conflict

  • Veracity: Pharmacists have an obligation to speak truthfully about medication errors to patients and families.

  • Nonmaleficence: A duty to avoid causing harm must guide interactions and decisions, especially while discussing errors that could affect patient safety.

  • Fidelity: Commitment to loyalty and trust relates to patients and families should be maintained when discussing ethical decisions and safeguarding their rights.

  • Decisions should weigh potential benefits against harms carefully to uphold ethical standards.

Distinct Perspectives in Ethical Decision-Making

  • Case: Over-the-Counter Diet Pills

    • Engage in evaluative judgments about the risks and benefits associated with recommending weight-loss drugs.

    • The pharmacist's role encompasses balancing patient education with ethical obligations tied to informed consent, transparency, and advocacy for patient safety.

Conclusion

  • Ethical decisions in pharmacy demand a nuanced understanding of various principles, models, and the ability to reflect on complex clinical contexts.

  • Continuous evaluation of ethical conflicts and potential consequences is pivotal to uphold ethical standards and deliver quality patient care in clinical practice.

The 80/20 Rule, also known as the Pareto Principle, states that roughly 80% of effects come from 20% of causes. In various contexts, this principle highlights the importance of focusing on the most impactful elements:

  • Application in Business: 80% of sales often come from 20% of clients, indicating the need to prioritize relationships with those key clients to maximize revenue.

  • Time Management: Identifying the 20% of tasks that yield 80% of results helps in prioritizing work and improving productivity.

  • Education: 20% of study material may cover 80% of information necessary for exams, guiding students to focus their efforts effectively.

  • Problem Solving: In troubleshooting, concentrating on the 20% of issues that cause 80% of problems can lead to quicker resolutions and greater efficiency.

By applying the 80/20 Rule, individuals and organizations can strategically allocate resources and efforts toward areas that yield the highest returns.